Initial Investor Survey Template

Please fill out the questionnaire below

2. Are you an Accredited Investor? *This question is required.

3. Have you ever invested in a Private Placement/506 Reg D fund in the past?

3. How much of your PERSONAL capital are you ready to deploy? *This question is required.

3. In what time frame are you looking to deploy personal capital? *This question is required.

3. Do you currently own Notes in your personal portfolio? *This question is required.

3. What else would you like us to know about your investment needs?

4. First Name *This question is required.

5. Last Name *This question is required.

6. Email Address *This question is required. This question requires a valid email address.

7. Phone Number *This question is required.

8. Zip Code *This question is required.